CAP Pro Course - Urinalysis - Serous and Synovial Fluid Analysis (2026 & 2027)

Author: Andrea Gordon, M.Ed., MLS(ASCP)SH
Reviewer: Margaret Reinhart, MS, MLS(ASCP) and Joshua J. Cannon, MS, MLS(ASCP)CMSHCM

Continuing Education Credits

Objectives

  • Describe the formation and function of synovial fluid and relate laboratory findings to various synovial fluid disorders.
  • Describe the formation and function of serous body fluids and relate laboratory findings to various serous fluid disorders.
  • Identify and explain how to perform identified laboratory test procedures that are utilized for evaluation of serous and synovial fluids.
  • Identify cells that are normally seen in serous and synovial fluids and distinguish malignant from benign serous fluid cells.

Course Outline

  • Describe the formation and function of synovial fluid and relate laboratory findings to various synovial fluid disorders.
      • Synovial Fluid Formation and Function
      • Classifications of Synovial Fluid Disorders
      • A knee fluid was collected from a 23-year-old male patient who had sustained an injury while playing rugby. The fluid was red, cloudy, and had low vis...
      • A 63-year-old female patient has suffered from osteoarthritis for several years. For the past week, she has felt increased pain and noticed more swell...
      • A student training in the hematology laboratory is learning that synovial fluid samples can present challenges due to difficulty with pipetting or ana...
      • You are observing the microscopic, unstained image of synovial fluid at 400x from a patient with an unknown diagnosis. Which of the following characte...
  • Describe the formation and function of serous body fluids and relate laboratory findings to various serous fluid disorders.
      • Serous Fluid Formation
      • Pathologic Causes of Serous Effusions
      • Transudates and Exudates
      • Table: Laboratory Differentiation Between Transudates and Exudates
      • A 32-year-old woman having pain in the lower left abdominal area has about 1.5 liters of fluid removed from her peritoneal space. This fluid has a cle...
      • Alcoholic cirrhosis is a common finding in North America. This condition will most likely result in which of the following?
  • Identify and explain how to perform identified laboratory test procedures that are utilized for evaluation of serous and synovial fluids.
      • Serous Fluid Cell Counts
      • Synovial Fluid Cell Counts
      • Manual Cell Counts
      • Automated Body Fluid Cell Counting
      • Body Fluid Smear Preparation
      • Synovial Fluid Crystal Identification
      • A pleural fluid is received in the laboratory with an order for cell count and differential. The fluid is yellow and clear with fair viscosity. It was...
      • A synovial fluid was received in the lab with a request for a crystal search. The fluid was examined using a compensated polarized light. The image to...
      • A cell count was requested on a knee fluid. The hematology laboratory uses an automated cell counting instrument approved by the FDA for body fluid ce...
      • A patient's pericardial fluid sample gives the following results:White blood cells = 23/µLRed blood cells = 1869/µLCrystals present = noneCo...
  • Identify cells that are normally seen in serous and synovial fluids and distinguish malignant from benign serous fluid cells.
      • Serous Fluid Normal Cell Identification
      • Synovial Fluid Cell Identification
      • Characteristics of Benign and Malignant Cells in Serous Fluids
      • Nuclear Characteristics of Benign and Malignant Cells in Serous Fluid
      • Cytoplasmic Characteristics of Benign and Malignant Cells in Serous Fluids
      • Characteristics That Distinguish Mesothelial Cells From Malignant Cells
      • Pleural fluid from a 54-year-old female patient was delivered to the laboratory for analysis. She had previously been diagnosed with stage 3 breast ca...
      • The cells shown in the image to the right are from a pericardial fluid with a normal nucleated cell count. What is the identification of these cells?
      • A pleural fluid sample is received and is hazy, pale yellow, with a nucleated cell count of 128/µL. A Wright-stained smear shows the cells in the...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS, MT, and MLT personnel, medical laboratory science students and interns, pathology residents, and practicing pathologists.
Author Information: Andrea G. Gordon, M.Ed, MLS(ASCP)SH has over 25 years of experience as a Program Director for various laboratory science programs. She has approximately 5 years experience as an administrator in higher education as a VP and Director of Education. Additionally, she has over 15 years of experience as a volunteer for NAACLS.
The author has no conflict of interest to disclose. 
Reviewer Information:
Margaret Reinhart, MS, MLS(ASCP) is a Senior Lecturer in Biological Sciences at the University of the Sciences in Philadelphia PA where she teaches hematology, clinical immunology, parasitology, and other related courses. She was the MLS Program Director there for 30 years. She is also an adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia PA. She holds a Masters Degree in Biology and in Health Care Administration.
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab by Vastian. His areas of expertise and professional passions include clinical hematology and interprofessional education. 

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